Exploring Collaborative Practice Agreements Between Nurse Practitioners And Physicians

Loading...
Thumbnail Image
Degree type
Doctor of Philosophy (PhD)
Graduate group
Nursing
Discipline
Subject
collaborative practice agreement
competition
nurse practitioner
occupational licensure
regulation
Nursing
Public Policy
Funder
Grant number
License
Copyright date
2019-04-02T20:18:00-07:00
Distributor
Related resources
Author
Ritter, Ashley Zampini
Ritter, Ashley Zampini
Contributor
Abstract

Purpose Twenty states, including Florida, require nurse practitioners to maintain a collaborative practice agreement (CPA) with a physician as a component of state occupational licensure. Occupational licensure can raise prices and limit access to services. Details regarding the terms and cost of participation in a CPA for providers are poorly understood. This study addressed three specific aims: 1) Examine the effects of collaborative practice agreements and similar models of health professional regulation on the cost and delivery of health services. 2) Describe variation in the collaborative services provided by physicians to nurse practitioners under collaborative practice agreements and explore associations between nurse practitioner employer, practice setting, and health professional shortage area (HPSA) with no physician terms in the CPA in Florida. 3) Describe variation in the cost of collaborative practice agreements provided by physicians to nurse practitioners and explore associations between nurse practitioner employer, practice setting, and HPSA with payment by the nurse practitioner for the CPA in Florida. Methods A multi-methods study with distribution of an electronic survey to nurse practitioners in Florida with two-steps of recruitment at the Florida Nurse Practitioner Network Annual Conference and via email utilizing publically available licensure. Data analysis included descriptive statistics, chi-squares, and qualitative descriptive methodology. Results Structures of regulation similar to CPAs in various health disciplines increase the cost of health services and decrease the number of health professionals delivering care. CPAs include vague language, and 24% of nurse practitioners in Florida report no terms of physician collaboration in the agreement. Ten percent of nurse practitioners report paying a physician for participation in a CPA. Nurse practitioner self-employment and non-hospital practice setting were associated with no terms for physician collaboration and payment to the physician for participation in the CPA. Collaborative practice agreements with no terms for physician collaboration were associated with payment to a physician for the CPA. Associations with HPSA demonstrate non- significant findings. Conclusions This dissertation increased our understanding of the structure, terms and cost of CPAs in Florida. Variability in the terms and cost of CPAs do not promote equitable conditions for nurse practitioner and physician collaboration.

Advisor
Julie A. Fairman
Kathryn H. Bowles
Date of degree
2018-01-01
Date Range for Data Collection (Start Date)
Date Range for Data Collection (End Date)
Digital Object Identifier
Series name and number
Volume number
Issue number
Publisher
Publisher DOI
Journal Issue
Comments
Recommended citation